Scientific advancements occurred these last years are full of promise for dermatology. Let us review those which are likely to bring change.
Nanoparticles, 3D printing, smart algorithms or digital consultations are now considered as solutions which might revolutionize the dermatological field. Here are new technologies that are, barring unforeseen circumstances, likely to shape tomorrow’s diagnosis and treatments in dermatology.
Telemedicine : a double-edged sword
The development of teleconsultation initiated debates about its reliability. On the one hand, it provides significant opportunities to cut patient waiting times and facilitate physicians scheduling. What’s more, it enables avoiding useless "physical" consultations while improving health care access in territories where medical services are limited. As for medical costs, some american studies show they might be lowered teleconsultation is implemented adequately.
However, many inherent risks with the technology itself are worth mentioning. First, the issue of personal data protection will be all the more significant for patients as they will have to give information on their health directly through applications. Also, the need for clear communication in every consultation might be difficult to meet, either because of poor video quality, or because social interactions online do not necessarily encourage people to speak out freely. In any case, both situations can lead to malpractice or misdiagnosis. Lastly, let us add that all medical offices and hospitals will have to think about repayment method.
As a matter of facts, any medical organization wishing to set up tele-consultation service should know not only the patient views on the matter, but also the economic and technological means at their disposal. Besides, it has to be reminded that there are two main consultations methods (live interactive and store-and-forward), each one having its own specificities. Consequently, practitioners have to determine which of these two methods is the best for patients. By way of conclusion, dermatologist Robert Stavert from Yale University summed up the situation as follows in a conference last summer at the AAD (American Academy of Dermatology) : "teledermatology platforms can provide significant benefits to patients and health care systems, but not all teledermatology services are created equally. It is important that the dermatology community continues to support systems that provide high-quality care, sustained by fair reimbursement, while deterring patients from utilizing services that are poorly designed and have the potential to cause harm.”.
Nanoparticles : a new "miracle cure" for cosmetics and oncology ?
Nanoparticles recently showed promise in cosmectics and oncology through experimentations. Indeed, nanoelements can now be found in sunscreens and anti-aging products. These breakthroughs may enable delivery of retinoids, antioxidants, and drugs such as botulinum toxin for rejuvenation of the skin in the future.
The fight against cancer also pins its hopes, amongst others, on nanotechnologies. Many experiments demonstrated that gold nanoparticles, when irradiated by a specific wavelenght, are able to burn cancerous cells with a high degree of precision. Expectations about this scientific development are high in the field of dermatology, especially for the treatment of melanoma cancers.
An increased use of sensors to prevent diseases
As the sensors market is booming, we are witnessing the emergence of many connected devices that are likely to be helpful to dermatology. Currently focused on data measurement, their functionalities may be expanded to diagnosis and treatment. L’Oréal exemplified this evolution when it launched in 2016 a sensor supposed to warn its users when their UV exposure starts being too high, in order to prevent cancers or sunburns. Treatment is also concerned in so far as some tests on patches, conceived to eradicate cancer cells, showed positive results. This research was presented in 2012 by an indian team at the Society of Nuclear Medecine’s Annual Meeting, since this technology is made possible by the use of phosphorus-32, a radioactive isotope used to treat some types of cancer. This advancement brings optimism for onco-dermatology.
Robotics : the use of multitasks machines
Robotics is now used in varied disciplines and practices of medecine, and diagnosis is probably the most notable of them for dermatology. Through a 360-degree scan, machines like Vectra VB360 now enable physicians to do complete analysis of the entire body to identify all skin lesions for one patient. Another usefulness is the future opportunity to conduct laser therapies to treat specific cancer types. A study carried out last year proves the superiority of robots over human beings in performing and managing this treatment.
3D printing and treatment of damaged human tissues
3D printing appears today as a solution to organ shortage, but also to the tricky issue of scientific experiments using living beings as guinea pigs. This way, functional human skin prototypes have already been synthesized within the framework of universitary research, which opens new opportunities to solve these problems. Nevertheless, 3D printing is not the only solution being explored to treat skin damages since researchers recently developed innovations aiming at accelerating tissue regeneration process. The use of specific extra-cellular matrixes and the development of specialized sprays considerably improve regeneration process, not only through the speeding mentioned before, but also through a bigger extent of the healing.
Artificial intelligence VS real doctors
The exponential growth of scientific and medical knowledge created an information overload that any practitioner, no matter how learned and committed to their own discipline, cannot face alone. As ongoing data compilation and research update is necessary to improve health care in all its aspects, computers should increasingly be required to perform these huge tasks that no human being could ever achieve. That is why IBM conceived a supercomputer named Watson. Thanks to machine learning and its ability to gather a massive amount of data, Watson can diagnose a very large number of pathologies, even rare or complex ones. For instance, an experiment conducted by IBM T.J. Watson Research demonstrated that Watson could, on average, better identify melanomas than real dermatologists. Noel Codella, research staff member at IBM, explained the results as follows to MedGadget last year : "We’ve published a report where we took one of the systems we had trained on some data and evaluated it on a test dataset. Within this dataset, a subset of a hundred images were also evaluated by eight top experts in the field who were looking at the images and trying to evaluate which were melanoma or not. Of those hundred images, we drew a direct comparison between our techniques and the dermatologists. From that study, we saw that our system was able to achieve a 76% accuracy, while the average accuracy for the eight dermatologists on that dataset was 70.5%. So it was promising study that showed potential for this technology to be helpful here".
However, two pitfalls need to be avoided : protecting personal data (in April 2019, Watson had already collected data about more than 300 million patients) and the risk of biased results due to disparities between countries, which raises new issues about legal responsibility. In any event, this invention is likely to turn upside down many fields of medicine like dermatology, oncology, medical imagery, cardiology, orthopedics and ophthalmology. Such tools, feared as a potential substitute of doctors, are now limited to providing decision-making guidance.
An intelligent use of social media ?
Given that Facebook, Twitter, Linkedin and many more social media acquired a huge number of users, they are now considered as potential tools to teach or inform people about health issues. For example, the portal Webicina is designed to drive surfers towards the most adapted and qualitative websites or applications for the subject they want to learn about. This tool might consequently be beneficial for any health care professional looking for the best digital resources available. As for social networks, they can play a prominent part to raise awareness about specific issues, particularly through health information campaigns. Last year, the American Academy of Dermatology launched a "SPOT Skin Cancer campaign" spurring women to get tested for skin cancer. Also, the AAD created a hashtag #SpotSkinCancer inciting web users to share pictures or videos aiming at bringing awareness about the importance of detecting skin cancers early.